Gastroscope



Dec. 2, 1969 J. A. GLASSMAN 3,

GASTROSCOPE Filed March 31, 1966 2 Sheets-Sheet 1 "1 INVENTOR J. A.GLASSMAN GASTROSCOPE Dec. 2, 1969 2 Sheets-Sheet 2 Filed March 31, 1966Jacob A. EVENTOR lassman,

3,481,325 GASTROSCOPE Jacob A. Glassman, 1680 Meridian Ave., MiamiBeach, Fla. 33139 Filed Mar. 31, 1966, Ser. No. 539,208 Int. Cl. A61b1/06, 1/26 US. Cl. 128-8 Claims ABSTRACT OF THE DISCLOSURE The inventionrelates to gastroscopes and more particularly to the novel constructionand assembly of a gastroscope useful in the visual exploration of thelining of the human stomach and duodenum.

The implement is designed to provide novel means for determining theprecise nature and location of a source of internal bleeding occasionedby a gastric or duodenal ulcer, esophageal varices, or focal points ofnecrosis, occurring in the gastric mucosa. The instrument is used duringsurgery and it includes a tubular structure with a wide mouth that ispressed against the mucosal surface and manipulated to eliminateoverhanging folds or rugar to thereby provide a smooth surface forcloser observation through an eye piece with the aid of a distal orproximal light source therein contained. The light source is mounted topermit it to be moved about within the assembly to rearrange light andshadow and thereby increase visibility. In these respects, and in otherdetails of structure, the present gastroscope distinguishes over otherknown types of proctoscopes and sigmoidoscopes and also in the fact thatno obturator is required during insertion. When the tubular structure ismade on a reduced scale for exploration of the duodenum, the instrumentmay be referred to as a duodenoscope hence, in the within descriptionand claims, the use of the term gastroscope is intended to includeduodenoscope.

It is therefore an object of the invention to provide a novelgastroscope.

Another object is to provide a gastroscope with an enlarged distal end.

Another object of the invention is to provide a gastroscope with amovable light source.

Another object is to provide a gastroscope with means to facilitatepurse string attachment of the incised edges of a stomach.

Another object is to provide a gastroscope with a tubular structure thatincludes a proximal end portion of uniform diameter and a progressivelyflared outwardly distal end portion.

Another object of the invention is to provide a gastroscope of novelconstruction which embodies means to facilitate the pushing aside ofmultifolded rugae to obtain better viewing of the gastric mucosa.

The structure by means of which the above noted and other advantages andobjects of the invention are attained will be described in the followingspecification, taken in conjunction with the accompanying drawings,showing a preferred illustrative embodiment of the invention, in which:

FIG. 1 is a longitudinal sectional view of the instrument, showing it inplace against a flattened out segment of a stomach mucosa, illustratedgraphically.

A United States Patent 0 3,481,325 Patented Dec. 2, 1969 "ice FIG. 2 isa perspective view showing the instrument inserted in one positionthrough a stomach incision to explore the upper portion thereof.

FIG. 3 is a view similar to FIG. 2, showing the instrument in anotherposition within the stomach, to explore the bottom or lower portionthereof.

FIG. 4 is a view showing the instrument inserted in the duodenum.

The instruments herein disclosed are inserted through an incised openingin the stomach 10 (FIGS. 2-3) or the duodenum 10a (FIG. 4) duringsurgery. The instrument shown in FIGS 2 and 3 and in FIG. 4 are alike inall respects except that in the FIG. 4 illustration, the tubular portionthereof is smaller than that shown in FIGS. 2 and 3. The instrument iscomprised essentially of an elongated tube-like body 11 including asubstantially tubular proximal end portion 11a and an outwardly flareddistal end portion 11b. In the larger of the tubes shown (FIGS. 2-3) theproximate end 11a is about three inches long and about one inch indiameter and the distal flared portion 11b which is about twice thelength of the portion 11a, has a mouth of approximately three inches indiameter.

The open end or mouth of flared portion 11b is disposed at an angle tothe tube axis as shown at 12, to facilitate its use and its free edge isheaded or otherwise formed, as at 13, to afford a smooth non-injuriousedge. When inserted through an incised opening, a purse string 14 isdrawn around the margins of the incised opening to draw said marginsfirmly about the tube-like body; spaced circumferential recesses orchannels 15 being provided for this purpose on the exterior surface ofsaid body. Preferably, the interior surface of the tube-like body istreated to prevent optical glare.

The free end of the tubular end portion 11a is threaded externally toreceive thereover a mounting ring 16 carrying a handle 17. Also threadedonto said end is a lens assembly comprised of a mounting band 18 and amagnification lens holder 19 which may be pivotally or detachablyconnected to the mounting band to enable it to be moved out of place orremoved for cleaning or other purposes.

Arranged within the tube-like body is a light source 21, which may be adistal light, as shown, or a proximal light. In either event the lightbulb is mounted on a fixture 22 that is mounted in the eye piecemounting band 18 and extends to the outside thereof and is connectedthereto by means of a pivotal or swivel joint 23 to permit the lightsource to be swung about within the tube-like body for the purpose ofrearranging light and shadows during examination and facilitate bettervision and localization of small bleeding sites.

When the instrument is in place in the stomach and the lens holder 19closing the proximate end, the stomach may be distended by airinsuffiation to eliminate folds and rugae and to this end the eye piecemounting band 18 is provided with an air inlet fitting 24 to which isattached a flexible conduit 25 (preferably rubber) having an inflatingbulb 26 (also preferably rubber) attached to it.

In use, the wide end 11b of the instrument is inserted through theincised opening without the aid of an obturator and the margins of theincision are secured around the tube by purse string 14. The instrumentlamp 21 is lighted and the instrument end or mouth 12 is moved gentlyagainst the gastric rugated mucosa or stomach lining to eliminate thegiant folds or rugae that overhang and, while viewing same through theeyepiece, the instrument is moved over the lining and simultaneouslyrotated to explore its entire surface. Exploration is aided by varyingthe position of the light source torearrange light and shadow on thegastric surface being explored.

It should be evident that because of the screw threaded mounting of thehandle, the tube-like body can be rotated about its axis without handlemovement, while in place within the stomach, and that upon removal ordisplacement of the eye-piece, access may be had to the stomach interiorthrough the tube-like body for treatment of the stomach surface, such aselectro-coagulating and use of dissecting tips.

Although I have described a preferred embodiment of the invention, inconsiderable detail, it will be understood that the description thereofis intended to be illustrative, rather than restrictive, as many.details of the structure may be modified or changed without departingfrom the spirit or scope of the invention. Accordingly, I do not desireto be restricted to the exact construction shown and described.

I claim:

1. A gastroscope comprising a rigid substantially tubular one-piece bodyopen at both ends, said body being of substantially uniform diameter ofabout one inch for approximately one-third of its length adjacent to oneend and having its remaining portion flaring gradually outwardly towardthe other end and terminating in a large diameter distal endapproximately three times the diameter of the proximate end and disposedon a bias, an electric lamp movably mounted within said body for sweepmovement within the interior thereof, lens means closing said one end ofthe body, and an air conduit having communication with the smaller endof said body.

References Cited UNITED STATES PATENTS 1,913,780 6/1933 Wappler 128-62,479,237 8/1949 Held 1286 2,583,937 1/1952 Fossati 1284 3,044,461 7/1962 Murdock 128-4 3,261,349 7/1966 Wallace 128-6 3,261,350 7/1966Wallace 1286 3,269,387 8/ 1966 Wallace 1286 FOREIGN PATENTS 365,049 12/1922 Germany.

606,742 12/ 1934 Germany.

412,656 7/1934 Great Britain.

RICHARD A. GAUDET, Primary Examiner K. L. HOWELL, Assistant Examiner

